Healthcare Provider Details

I. General information

NPI: 1720079817
Provider Name (Legal Business Name): MAHMOUD H TEHFE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

662 MORRIS PARK AVE
BRONX NY
10462-3503
US

IV. Provider business mailing address

1326 BAY RIDGE PKWY
BROOKLYN NY
11228-2211
US

V. Phone/Fax

Practice location:
  • Phone: 718-597-3380
  • Fax: 718-597-0094
Mailing address:
  • Phone: 718-597-3380
  • Fax: 718-597-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043545
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: